Our health experts answer your questions. This week: the benefits and dangers
of the 5:2 diet and dealing with dizziness.

Q: I read in the Telegraph about the 5:2 diet. It appeals to me, as it only involves restricting one’s food on two days of the week, which feels manageable. However, I am worried that I would have an energy crash and not be able to get through the day. What are the benefits and dangers?

A: Dan Rutherford writes:

The 5:2 diet involves eating your usual amounts of food five days a week and restricting your calorie intake to about 500-600 per day on the two other days, which should be non-consecutive. This represents an overall drop in calories of about 25 per cent for someone normally eating around 2,500 calories daily.

Anecdotal evidence suggests that many people have found this type of diet to be one they can live with. Unless you have a medical condition like diabetes, in which case a regular daily food intake is very important, then most people who are in good health but who are trying to lose excess weight are unlikely to come to any harm trying the 5:2 diet.

Perhaps you will initially experience an energy dip at some point during the day as you use up your body’s stores of quick-release glucose, and the challenge then will be to avoid snacking your way out with crisps and chocolate. Low-calorie snacks prepared in advance will reduce that risk. You can look at research papers on diets all day and not find the answer for you personally. Give it a go and find out for yourself.

A: Sara Stanner writes:

Champions of the 5:2 diet claim that in addition to weight loss it offers lots of other health benefits, including increased lifespan and protection against age-related diseases such as cancer, dementia and Alzheimer’s. Most studies looking at the health effects of intermittent fasting have been carried out on animals. We need more research to compare its effects with conventional calorie-controlled diets and to determine its impact on health in the long term.

Common side-effects of fasting are a lack of energy, irritability, anxiety and difficulty sleeping. So before you embark on this approach, think about how fasting might affect your normal activities such as your ability to work and be active. If you still decide to give it a go, spread the calories between meals sensibly and opt for filling, low-calorie foods, like a small bowl of Bran Flakes and skimmed milk for breakfast, soup and an apple for lunch, and a small portion of grilled fish with vegetables for dinner.

Any side effects will be worsened by dehydration, so make sure you drink plenty of water on the fasting days. The diet is not suitable for people with diabetes, or pregnant or lactating women.

SITTING COMFORTABLY

Q: I work in an office, sitting down. I am experiencing stiffness and weakness on the left side of my lower back. I am 34 and feel a bit young for this. Any suggestions?

A: Tony Gallagher writes:

Your complaint may or may not be due to sitting down, but staying still for long periods is probably not helping.

For many members of the workforce, exercise levels per se are not always a problem compared to spending hours in front of a computer without moving. Studies suggest that people who sit the most have the highest risk of diabetes and heart disease. In the past, high blood pressure was thought to be the silent killer; now inactivity gives us cause for a great deal of concern. You can reach your weekly fitness activity target but still be at risk of ill health if you spend the rest of the time sitting.

Unfortunately for many people it is difficult to avoid sitting down for six hours a day – as well as when commuting or relaxing at home. Research indicates that some adults spend more than seven hours a day sitting down – and not just office workers. People in the over-65 age bracket spend 10 hours or more each day sitting or lying down, which makes them by far the most sedentary group.

The weakness on your lower back may simply be caused by poor posture. Some companies have in-house fitness classes which break the day up from a physical viewpoint. But it still doesn’t fully address the challenges of being immobile for many hours.

Try and sit at an angle of 135 degrees, which is will put less strain on your back than hunching forward or sitting at 90 degrees. Every 15 minutes, either walk around, stretch, or venture over to a colleague’s desk instead of calling or sending an email. This is usually achievable, and it quickly becomes a healthy habit.

A more dramatic solution is the treadmill desk, which allows workers to walk while working. They are perhaps a bit gimmicky, but the principle is sound.

Some companies have invested in desks with adjustable heights, which means users can alternate between sitting and standing during the day.

You could simply use a pedometer and set yourself a target of 10,000 steps a day, which should then encourage you to be more mobile generally around the office and hopefully at home, too.

DEALING WITH DIZZINESS

Q: I have noticed that I tend to get dizzy whenever I make very sudden movements, like swinging my children around, getting out of bed, or looking over my shoulder when driving. Should I be concerned?

A: Dan Rutherford writes:

Movement-related dizziness tends to come from malfunction of the balance mechanism of the inner ear. The likeliest causes vary depending on the age of the person and whether there are other medical issues. For example, in someone under 30 who is fit, a viral inner ear infection called “labyrinthitis” is the most common reason. This will produce dizziness that goes away after a week or two, but can last longer. In someone over 60 who has high blood pressure and smokes, one is more likely to consider poor blood flow to the inner ear or the brain, such as hardening of the arteries in the neck, or even a small stroke.

A not uncommon cause, seen across the age groups, is tiny particles floating within the semicircular canals or “spirit levels” of the middle ear.

As these particles bump into the movement-sensing hairs within the canals, false information is sent to the brain and it makes you feel as if you are moving. A series of head positioning exercises called 'Epley’s manoeuvre’ can help. I advise you to see your GP first though, so you know what you are dealing with.

RECUPERATIVE FOOD

Q: I recently had a bad bout of Norovirus, and it has left me depleted and sensitive to food. I can’t eat anything rich, cold, or sharp. Can you recommend any strength-building foods that are very plain? And are there any pick-me-up medications available in chemists?

A: Sara Stanner writes:

Starchy foods like potatoes, bread and rice are easy to digest and will provide you with the energy your body needs during its recovery. You also need foods that are rich in protein to help to build and maintain muscle mass and strengthen your immune system.

Grilled, poached or baked chicken, particularly without the skin, is easy to digest and provides valuable protein, iron and B vitamins. Many people swear by chicken soup when they are recovering from a virus; soups tend to be easy on the stomach when you have been ill, and you can boost your protein intake by adding lentils or beans to home-made vegetable broth. Baked or poached white fish and eggs are good options, too.

Yogurt is a mild-tasting, smooth food that offers numerous nutritional benefits and some types have beneficial probiotic bacteria added to them. A recent study in elderly people suggested that probiotics containing the Lactobacillus casei strain 'Shirota’ might help alleviate the fever associated with Norovirus.

Opt for mild rather than acidic fruits, like bananas, watermelon, plums and ripe pears. You can also use these to make smoothies. Adding skimmed milk powder to smoothies, milk-based soups or milky desserts is an easy way to boost their nutritional value.

Small, frequent meals tend to be easier to digest than larger ones. Make sure to drink plenty of fluids to stay well hydrated.

If you’re concerned that your diet is restricting important nutrients, you may benefit from a multivitamin supplement until your appetite and taste buds return to normal.

WEIGHTY SUPPLEMENTS

Q: I am thinking of taking supplements to aid my weightlifting training, but I have heard that some can be damaging.

A: Tony Gallagher writes

It is thought that an overload of protein or creatine can strain your kidneys and liver, and weight training supplements provide a high level of those substances. Therefore it is vital that the label directions are always followed.

Your body is only able to process so much protein at one time, so it is best to spread out your consumption.

Supplements will not replace a good meal but will add nutrients to the body for weight training. Top-quality nutrition works at an optimum level when combined with intelligent weight training. This means carefully balancing your exercise and your nutrition, and making sure that you take adequate rests in between workouts.

You can consider taking a weightlifting supplement if it feeds the body with the right amount of nutrients. I would advise you to consult a qualified coach and exercise great caution if buying supplements online.